amirhossein
Forum Guru
Topics: 57
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Yesterday, I took the exam. It was not that much hard. However you must be kinda pro to be happy after exam.
Day 1:
I arrived early at 7:15 AM at exam center. The lady over there asked me the letter permit. I showed her my printed email from prometric center. Firstly, she didn't accept that and asked me for something like an official letter from FSMB. I did't have it and it maked me nervous, coz I hadn't received anything from them. She maked some calls and I showed her the number on my print, and told her this is a new thing that they don't send letter anymore. She realized the fact and let me in. Just remeber, some proctor may don't know about the new email thing. explain to them. I started my exam at 7:30 AM and finished at 3:30 PM. Break Time: 45 min, Tutorial: 15 min. Add this 15 min to your break time by fast reading tutorial in case you won't miss anything.
It was 336 (48 Qs x 7 Blocks) in three setting: Office, ward and ER. The ER was the easiest and the inpatient was the hardest one, barely I had enough time to review the marked questions. So, do't waste your time to mark a question and try to use the keyboard (striking A-E for correct choice and then press Enter). Seconds are very valuable.
Regarding breaks, each time I went for break and started a new block afterwards, it took me some time to concentrate again and it took me 7-8 min to answer to first 3 questions, so I tried to limit going for break. it works for the first blocks, but in the afternoon you are almost depleted of any neurotransaminase in your brain! so take a break for every last 3 blocks.
Don't leave any questions unanswered and if the block is about to finish and you have one unread question, first answer blindly, then read the question. Unlike step 1 and 2, the block will close even if you haven't answered the last question. There is so many times that you can answer a question by just reading the last sentece of question? (e.g. what is the next step or what is the appropriate sentence in this setting) and then looking at the previous sentence for the striking P/E, labs or x-ray.
Even when I had time I tried to read last sentece first, to have an attitude reading the question. For example a long question about a patient with dementia with several other disease and polypharmacy and you concentrate all of those things, then finally you will asked about a local skin problem unrelated to all above. So first see what question ask you then read it.
Day 2:
Arrived early at 7:10 AM and started at 7:15 AM. In contrary to what people say about the second day, the questions are as hard as the first day, just less questions. It was four 45-min-blocks with 36 questions. The same as day 1, 75 seconds for each question. The same setting: Office, Ward and ER. Again inpateint question was the hardest. The hardest because almost all the cases are complicated and you have to manage them under the pressure of time. Sometimes, I knew the answer, but it wasn't there between choices, there is so many paraphrasing, that firstly look unfamiliar and you should think about them. This kind of things make the block hard.
CCS: My clinical cases were easy for diagnosis. Just from very common and usual cases, not complicated at all and smoothed very well. Just remember, don't assume you must find something striking in cases. How many times you have seen a perforated gastric ulcer or subarachnoid hemorrhage? Frist think about common cases and common causes of diseases.
In encountring the cases, try to write all important thing down on the laminated pages you have. You have time to write because every case takes time to download to your computer, even after the exam started, every time you want some info from patient or you want to give some order, it takes time and deducts from your total given 25 min. Try to use this time wisely. For example, if you see in the first line of Hx, a 62-year-old woman with chest pain and fatigue, think about DDx and write orders for yourseld on laminated page. The Second window that opens for Hx, will taper your DDx. On the third and the last Hx window, you will have HPI and PMH, FHx and SHx. While you develping your order, write a problem list that you will deal with it at the end of exam, for examle if you are seeing a depressed smoker old man who suffers sleep problem in addition to main problem, you will order relaxation at the end of exam; and so on for sreeng thing about a somking and prostate things.
Consultant do nothing for you. Just do your job, and write the order, the software will ask you about consultation.
If you don't remember what else you must do, write something about diseae in order part and search for it. For example, search abuse, diabetes, alcohol or depressin. You will surprised how well this works. Sometimes your mind blocks on the exam you should break it by this key.
The setting is very important. This is why if you see a patient in office or ward and order some labs, you will be asked "stat" or "routine", but it doesn't happen at ER, all labs are orderd as stat. Decide wisely, if the case is a chronic body pain, she/he doesn't need stat, order needed test and send patient home with something for pain, then give an appointment for 3-4 days later. By that time you will get the results and patient's updates form softwear. If there is something wrong in patient's lab, there is an asterick next to it.
Don't be afraid if your case doesn't end before 20 min, just do your job correctly. Sometimes if you have done all you should and advance time the case will end and softwear ask you about any further orders before closing the case in 5 min.
Practice with USMLE CD untill you master it.
This doesn't mean I will pass but this was all I got from exam. Hope it helps you for preparing the exam with at least some attitude.
Good Luck to everyone,
Amirhossein
Edited by amirhossein on 03/10/07 - 12:03 PM
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All human wisdom is summed up in two words: wait and hope
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| aimtomatch2007
Forum Newbie
Topics: 4
Posts: 29
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Thank you amirhossein. your post definitely helps for people to have a sense of the exam day. Can you tell me if the questions in the blocks are gropued into ER or inpatient or outpatient settings and will you know which kind of que you are dealing with during the exam? or is it the the block has a mix of all questions of different settings.
Thanks
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| amirhossein
Forum Guru
Topics: 57
Posts: 859
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As you see on USMLE CD, each block starts with a definition about setting, and all the quesions in that block related to that setting.
During tutorial, you will notify about the order and setting of blocks. During to test, if you hold Ctrl key with T, you can see the order of questions and different time of exam, including remaining break time.
When you finish each block the softwear ask you if you want to take a break or open a new block while showing the remaining break time.
___________________
All human wisdom is summed up in two words: wait and hope
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| aimtomatch2007
Forum Newbie
Topics: 4
Posts: 29
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Thank you amir. Good luck for the match!!!
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| kairavshah
Forum Junior
Topics: 6
Posts: 50
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hey... did you get your result? has it been reported yet?
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| amirhossein
Forum Guru
Topics: 57
Posts: 859
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Yes, My socre was reported within 3 weeks, check score thread.
___________________
All human wisdom is summed up in two words: wait and hope
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| kairavshah
Forum Junior
Topics: 6
Posts: 50
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congrats! nice score
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| whiterabbit
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good post
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